INCIDENCE AND RISK FACTORS FOR PROGRESSION TO END-STAGE RENAL DISEASE IN PATIENTS WITH DIABETIC NEPHROPATHY: A PROSPECTIVE OBSERVATIONAL STUDY.

Background: Diabetic nephropathy is a leading cause of end-stage renal disease (ESRD) worldwide. Identifying the incidence and risk factors for progression to ESRD in patients with diabetic nephropathy is crucial for effective clinical management. Objective: This prospective observational study aimed to determine the incidence and identify risk factors for progression to ESRD in patients with diabetic nephropathy. Materials and Methods: A total of 50 patients with diabetic nephropathy were recruited from 2018 to 2022 and followed for two years. Baseline demographic and clinical characteristics were collected. The primary outcome was progression to ESRD. Multivariate Cox proportional hazards regression analysis was used to identify significant risk factors for progression to ESRD. Results: The mean age of the patients was 60.4 ± 10.2 years, with 30 males (60%) and 20 females (40%). The average duration of diabetes was 15.8 ± 6.7 years. Baseline eGFR was 45.3 ± 12.6 mL/min/1.73 m², and baseline albuminuria was 430 ± 230 mg/g. During the follow-up period, 12 patients (24%) progressed to ESRD. Significant risk factors for progression included lower baseline eGFR (HR: 1.95; 95% CI: 1.12-3.42; p=0.01), higher baseline albuminuria (HR: 1.68; 95% CI: 1.03-2.75; p=0.04), and longer duration of diabetes (HR: 1.22; 95% CI: 1.05-1.41; p=0.02). Blood pressure control had a protective effect but was not statistically significant (HR: 0.75; 95% CI: 0.50- 1.12; p=0.16). Glycemic control showed no significant association with progression to ESRD (HR: 0.98; 95% CI: 0.87-1.10; p=0.72). Conclusion: This study highlights the high incidence of progression to ESRD in patients with diabetic nephropathy and underscores the importance of monitoring baseline eGFR, albuminuria, and diabetes duration. Early interventions targeting these risk factors may reduce ESRD progression. [ABSTRACT FROM AUTHOR]